Doctor Name: | MELISSA MANJARRES |
NPI Number: | 1407226301 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 4195-154 |
Business Practice Address: | 1000 N 92nd St Milwaukee, WI - 532263533 |
Business Phone Number: | 4144799495 |
Business Fax Number: | |
Mailing Address: | 10849 W Derby Ave, WAUWATOSA |
State: | WI |
Postal Code: | 532254558 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/05/2015 |
NPI Last Update Date: | 10/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4195-154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |